A massive transfusion protocol (MTP) in which most non-RBC transfusions were laboratory result-driven was updated to a 1:1:1 RBC/plasma/platelet formula-driven protocol. Platelet count, fibrinogen level, and prothrombin time (PT) monitored. In the patients who survived first 12 hours, results of coagulation tests analyzed. Irrespective MTP or transfused RBC/plasma ratio, majority became coagulopathic, usually within 2 deficiency (fibrinogen <100 mg/dL [2.9 μmol/L]) almost always initial...

Objectives Chest radiography has been the preferred imaging study to assess pulmonary congestion. However, chest interpretation is influenced by level of expertise and high interobserver variability. Lung ultrasound (US) may produce more objective findings through evaluation vertical comet tail artifacts known as B‐lines, which are created a decrease in ratio alveolar air fluid content. Few studies have directly compared bedside US against reference standard for diagnosis edema. This...

The purpose of our retrospective database analysis was to describe and evaluate the outcomes a weight loss intervention in community medical wellness center.Four hundred eighteen overweight obese adults entered program between 2001 2004. Forty-seven percent completed 6-month designed using standards recommendations established by NIH, American Dietetic Association, Academy Sports Medicine. Data limited 198 participants (142 women, 56 men) completing program.Individuals averaged 7.3% men 4.7%...

Previous literature has shown that propofol ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is paucity of information regarding patient satisfaction with propofol.The aim this study was to evaluate compared nonpropofol (fentanyl/midazolam) anesthesia colonoscopies. Safety and complications were secondary end points.This double-blind, randomized, parallel-group controlled clinical trial (NCT 02937506).This...

Objective: To evaluate orthostatic hypotension (OH) prevalence, risk factors, signs and symptoms, treatment response in patients with dementia. Background: No previous studies had systematically delineated the clinical features of OH dementia determined effects treatment. Diagnosing this treatable disorder may prevent severe consequences falls, syncope, confusion, ischemic brain injury, death; mortality rises worsening OH. Lesser include skin injuries, sprains, fractures, subdural hematomas....

CT is the standard of care for assessment traumatic injuries. Because detail depicted with this technique, findings incidental to injury are easily detected. We sought determine frequency and types in cervical spines trauma patients undergoing CT.The registry was accessed identify cases evaluated spine at a level 1 center from January July 2007. Trauma data, including age, sex, severity score, mechanism injury, length stay, diagnosis were recorded, all scans reviewed findings. Clinically...

Airway management is germane to safe patient care. Keys of difficult airways (DAs) are the "Right People, Right Parts, and Place" (R3P3). Successful DA requires clinicians who have adequate training, experience, equipment. Policies were implemented optimize DAs. One identified inpatients with potential DAs, whereas other addressed creation deployment "Alpha Teams" (ATs). In event impending respiratory compromise, an AT was called in same manner as a code blue. Health care providers educated...

To estimate whether vaginal-perianal cultures could be an alternative to the recommended vaginal-rectal screening for detection of group B streptococci (GBS) during pregnancy, and compare patient pain discomfort between two collection methods.Patients included were aged 18 or older at 35-37 weeks gestation. After consent, each underwent a followed by culture. Patients rated their on 0-to-10 scale method indicated one had more than other. The primary outcome study was proportion patients...

Oral and mandibular trauma pose barriers to oral thermometry. We sought determine whether temporal artery (TA) scanning thermometry could be an accurate, noninvasive back up method of in patients with these types traumatic injury. compared 3 techniques TA scanning, axillary thermometry, critical care patients. Our results indicate that methods were, at best, comparable measurements. In addition, the performance scanners varied body mass index, whereas readings did not.

Compared with other age groups, teenagers have the lowest rate of safety belt use. We sought to determine whether an ongoing, student-led initiative would be effective in increasing use among high school students compared another which intervention did not take place. At school, there was a statistically significant increase 15% observed and evidence increased knowledge regarding proper High schools can changing traffic behaviors its students.

Despite well-established protocols for cardiopulmonary resuscitation training, performance during real-life cardiac arrests can be suboptimal. Understanding personal characteristics which could influence of high-quality chest compressions provide insight into the practice-performance gap. This study examined compression performance, while employing feedback and introducing code team sounds as an anxiety-inducing factor in registered nurses using a training manikin.Participants included 120...

Dengue fever outbreaks have occurred in Port Sudan City, Sudan, during the last 2 decades. Climatic factors may play a role dengue incidence.This study aimed at discribing relationship between climatic and incidence 2008-2013.This ecological entailed secondary data analysis of cases climate information to explore which predict fever. The Wilcoxon rank sum test multiple linear regression examined association number lag times 1-6 months.Relative humidity maximum minimum temperatures were...

Objectives:This study describes the early experience of robotic prostatectomy exclusively at a teaching community hospital.Methods:This is retrospective report 153 consecutive patients on whom 4 physicians were operating surgeon.Results:The average hospital stay was 1.5 days, mean operative time 175 minutes, and estimated blood loss <300mL. The perioperative complication rate 7.8% (12/153). prostate-specific antigen failure 2% (2/114). Urinary continence maintained in 98% 9 months after...

In Brief PURPOSE Obesity increases the risk of developing physical disability and pain. Persons with a body mass index (BMI) 30 kg/m2 or more have an increased for osteoarthritis compared those BMI between 25 29 kg/m2. The purpose this study was to examine effect treatment directed at reducing musculoskeletal pain on weight loss in obese subjects prior participation 6-month management (WM) program. METHODS Subjects (BMI ≥ kg/m2; n = 54, female 41, male 13) pain, as assessed by visual analog...

Objective: Efforts to achieve balance between effective pain management and opioid-related adverse events (ORAEs) have led multimodal analgesia regimens. This study compared opioids delivered via patient-controlled (PCA) plus liposomal bupivacaine, a long-acting local anesthetic with potential be an component of such regimens, through PCA alone or subcutaneous bupivacaine infusion (ONQ), following laparotomy.Design: Prospective, randomized controlled trial.Setting: Single, tertiary-care...